LEIOMYOSARCOMA OF THE UTERUS (CASE FROM PRACTICE)
DOI:
https://doi.org/10.11603/1811-2471.2017.v1.i3.7788Keywords:
leiomyosarcoma, uterus, histological diagnostics.Abstract
Summary. Among malignant tumors of uterus leiomyosarcoma is met in 1 – 1,3% of cases. The main method of its diagnosis is histological investigation of operative material. Herewith difficulties in differential diagnosis with its benign counterpart – leiomyoma – are often met. In this published work we describe the clinical case of uterine leiomyosarcoma in 51-year old female, represent anamnesis and clinical data in details, as well as describe dynamics of the disease development. The main attention is payed to the key microscopic criteria of the leiomyosarcoma of the uterus. At its histological investigation there were found significant manifestations of smooth muscles remodeling. Nuclei of the myocytes had signs of deformity, were largely increased and hyperchromic, which all together indicated the difference between blood supply and cells proliferation inside the tumor. Nuclei polymorphism was observed diffusely, not focally. Besides there were pathological mitosis, necrosis, hemorrhages. This case from practice stresses out the difficulties of uterus leiomyosarcoma and myoma histological verification for practicing pathomorphologists.
References
Holovyn, D.Y., (1982). Oshybky y trudnosty hystolohycheskoy diahnostyky opukholey: (rukovodstvo dlya vrachey) [Errors and difficulties of histological diagnosis of tumors: (guide for doctors)]. Medytsyna – Medicine, 304 [in Russian].
Saparhalyeva, A.D. (2016). Sluchay leyomyosarkomy v leyomyome v praktyke patolohoanatoma s kratkym obzorom sovremennoy lyteratury [The case of leiomyosarcoma in a leiomyoma in the practice of a pathologist with a brief review of modern literature]. Medicine (Almaty), 35 (167), 19–24. [in Russian].
Frank, H.A. (2004). Problemy morfolohycheskoy klassyfykatsyy y dyahnostyky opukholey myahkykh tkaney [Problems of morphological classification and diagnostics of soft tissue tumors]. Praktycheskaya onkolohyya – Practical oncology, 5(4), 231–236. [in Russian].
Bodurka, D.C., Gershenson, D.M., Pollock, R.E., ed. (2002). Sarcomas of the female reproductive tract. American Cancer Society Atlas of Clinical Oncology. Soft Tissue Sarcomas. – Hamilton, Ontario: BC Decker, 213–227.
Dinh, T.A., Oliva, E.A., Fuller, A.F., Goodman, A. (2004). The treatment of uterine leiomyosarcoma. Result from a 10–year experience (1990 – 1999) at the Massachusetts General Hospital. Gynecology Oncology, 92(2), 648–652.
Giuntoli, R.L., Metzinger, D.S., DiMarco, C.S., Cha, S.S., Sloan Keeney, J.A., Goustaut, B.S. (2003). Retrospective review of 208 patients with leiomyosarcoma of the uterus: prognostic indicators, surgical management, and adjuvant therapy. Gynecology oncology, 89 (3), 460 – 469.
Ghaemmaghami, F., Zarchi, M.K., Gilani, M.M., Mousavi, A., Behtash, N., Chasemi, M. (2008). Uterine sarcoma: clinic-pathological characteristics, treatment and outcome in Iran. Asian pacific J. cancer prev., 9, 421–426.
Harry, V.N., Narayansingh, G.V., Parkin, D.E. (2007). Uterine leiomyosarcomas: a review of the diagnostic and therapeutic pitfalls. Obstet. and. Gynecology., 9, 88–94.
Silva, E.C., Bodurka, D.C., Scouros, M.A., Ayala, A.A. (2005). Uterine leiomyosarcoma that became positive for HMB 45 in the metastasis. Ann. Diagn. Pathology., 1, 43–45.
